Issue Raised About Pharmacist Use of Opioid-Monitoring Programs

By staff

Brunswick, ME—Most U.S. states have established prescription-monitoring programs (PMPs)—electronic databases that track prescriptions for opioids and other controlled substances—to identify possible cases of prescription drug misuse and help patients get treatment for addiction if needed.

The question raised by a study published in the Journal of Studies on Alcohol and Drugs, however, is how regularly pharmacists employ them.

A study in Maine, which has been hard-hit by the opioid epidemic, found that, although the state has had a PMP since 2004, many pharmacists reported not using it in 2014. Of 275 pharmacists surveyed by Bowdoin College–led researchers, only 56% said they were tapping into the program.

“Often, the pharmacist is the ‘last line of defense,’ for patient safety,” explained co-author Stephanie Nichols, PharmD, of Husson University School of Pharmacy in Bangor, Maine.

Based on the state’s PMP, opioids were prescribed to 22% of Maine residents in 2014—and the total amount of drugs was enough to supply every person in the state with a 16-day supply, according to the report. While that figure is down slightly from 2010, Nichols points out, “it’s still a very large number.”

For the study, the representative sample of pharmacists completed an online survey about opioids. Results of the survey were combined with county-level analyses of 1.22 million opioid prescriptions reported to the Maine Prescription Monitoring Program in 2014 and the agents implicated in 2,700 arrests as reported to the Maine Diversion Alert Program.

Results indicate that a significantly greater number of pharmacists agreed that opioid misuse (85.9%), rather than diversion (76.8%) or access (54.2%), was a concern.

Among the other findings is that opioids were prescribed to 37.7% of women in their 80s in Maine, and that buprenorphine accounted for almost half of opioid prescriptions to young adults—46.3% women and 49.3% men. Researchers say they consider it somewhat encouraging that prescriptions for oxycodone and hydrocodone were lower in 2014, while prescriptions for buprenorphine—typically used to treat opioid addiction—were up sharply.

“Pharmacists are very aware of the potential for opioid misuse, but many do not consistently use the [Maine PMP],” study authors conclude. “There continues to be substantial legitimate use, as well as criminal activity, involving oxycodone and other prescription opioids. Continued vigilance and use of tools like the PMP and [Diversion Alert Program] are necessary to minimize nonmedical use of opioids in Maine.”